Related Experiment Video
Updated: May 10, 2026
03:26
Fixation of Ultrasound Transducers for Spinal Cord Neuromodulation in Mice
Published on: August 1, 2025
Adjunctive vancomycin powder in pediatric spine surgery is safe
Itai Gans1, John P Dormans, David A Spiegel
1*The Children's Hospital of Philadelphia, Philadelphia, PA; and †The Hospital of The University of Pennsylvania, Philadelphia, PA.
Spine
|June 14, 2013
Summary
This study found that using vancomycin powder (VP) during pediatric spine surgery did not cause significant changes in kidney function or systemic levels. Intraoperative VP is a safe option for preventing surgical site infections in children.
Area of Science:
- Pediatric Orthopedics
- Infectious Disease Prevention
- Spine Surgery
Background:
- Surgical site infections (SSIs) are a concern in pediatric spine surgery, particularly those caused by methicillin-resistant Staphylococcus aureus.
- Vancomycin powder (VP) is used in adults to reduce SSIs, but its safety in pediatric patients is not well-documented.
- This study addresses the need for safety data on VP in pediatric spine surgery.
Purpose of the Study:
- To evaluate the safety of adjunctive local vancomycin powder (VP) application for infection prophylaxis.
- To assess VP's safety in posterior instrumented thoracic and lumbar spine wounds in pediatric patients.
- To determine the impact of VP on kidney function and systemic levels in pediatric patients.
Main Methods:
- A Level II cohort study reviewed data from 87 pediatric patients weighing over 25 kg undergoing spine deformity correction.
- 500 mg of unreconstituted VP was applied locally during surgery, alongside routine intravenous cephalosporin prophylaxis.
- Creatinine levels and systemic vancomycin levels were monitored preoperatively and on postoperative days 1 and 4.
Main Results:
- No significant changes in creatinine levels were observed postoperatively.
- Systemic vancomycin levels remained undetectable in all patients.
- No instances of nephrotoxicity or Red Man Syndrome were reported.
- Three out of 87 patients developed a surgical site infection.
Conclusions:
- Intraoperative vancomycin powder (VP) is safe for infection prophylaxis in pediatric spine surgery.
- VP does not cause clinically significant changes in renal function or systemic levels in this patient population.
- VP can be considered a safe adjunct for reducing SSIs in pediatric spine deformity procedures.
Related Concept Videos
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
01:29Drug Dosing: Infants and Children
Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
01:24Parenteral Anesthetics: Overview
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
01:22Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence
Generic intravenous (IV) drugs are considered bioequivalent to their branded counterparts due to their 100% bioavailability upon administration. However, variations in stability among different drug products can significantly influence their therapeutic performance, even if they are pharmaceutically equivalent.Cefuroxime, a prophylactic antimicrobial, is often used as a single-dose IV injection for patients undergoing coronary artery bypass grafting surgery. A 3 g dose typically provides...
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
01:19One-Compartment Open Model for IV Bolus Administration: General Considerations
The one-compartment model is a pharmacokinetic tool that models the body as a single, uniform compartment, facilitating the understanding of drug distribution and elimination. This model is particularly beneficial for intravenous (IV) bolus administration, where the drug rapidly circulates throughout the body.
The drug's presence in the body is defined by an equation representing the difference between the rates of drug entry and exit. Key parameters—elimination rate constant, half-life,...
The drug's presence in the body is defined by an equation representing the difference between the rates of drug entry and exit. Key parameters—elimination rate constant, half-life,...